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How and why the coronavirus numbers in Italy have risen so sharply

Italy's coronavirus situation has changed dramatically in just one month - but why? And are things really worse now than in March? Here we take a closer look at the data.

How and why the coronavirus numbers in Italy have risen so sharply
Milan's Galleria Vittorio Emanuele II on October 17th- Photo: Miguel Medina/AFP

On September 18th, Italy was in a relatively good position – both compared to its European neighbours, and compared to its own situation back in spring.

Just one short month later, there has been a marked change.

On September 18th there were 1,907 new infections. The figure on October 18th was 11,705. 

The number of new infections being reported daily now exceeds that seen at the beginning of the emergency.

Over the past two weeks the number of symptomatic new cases almost doubled: from around 8,000 to 15,189, according to Italy's Higher Health Institute (ISS).

While the number of new infections has been making headlines, other data give a more complete picture of just how much the situation in Italy has changed.

Analysis shows that hospitalisations overall have risen from 2,387 a month ago to 7,131 as of October 18th.

And the total number of people known to be infected in Italy has risen by almost 200 percent over the past month, from 42,457 to 126,237.

These figures have been slowly rising in recent weeks, but the curve is now rising “exponentially”, experts say.

They point out that the number of people in intensive care in Italy has almost doubled in just the past 11 days., rising from 358 to 705.

 

Why has the number of new infections risen so quickly?

Italian health authorities found that the vast majority of new infections at the moment take place between family members.

The latest weekly report from the ISS, released on Friday, found 80.3% of new infections “occurred in a home environment” while only 4.2% were through recreational activities and 3.8% in schools.

The number of cases with unknown origins is rising, with over 9,000 last week.

The ISS also warned on Friday that people must “avoid events and gatherings in public and private places”.
 
New anti-contagion measures from the Italian government focused on preventing crowds, particularly in nightlife areas.
 
And as Lombardy prepares to introduce an evening curfew this weekend – the strictest measure seen in Italy since lockdown eased – one doctor offered an explanation for the region's chronically high number of cases.
 
Francesco Bini, head of the pulmonology department at Milan's Garbagnate Hospital, told AFP that Lombardy's population density and business activity was exacerbating transmission of the virus.
 
“Lombardy is a very dynamic region, very active, with a large population, concentrated particularly in the cities,” Bini told AFP.
 
“Doing a lot of things, seeing a lot of people, having a lot of work and meeting activities facilitates the spread of the virus.”

Are things really worse now than they were in March?

Italy was blindsided when it became the first country to be hit by a major coronavirus outbreak. The little testing available at that time focused on those showing symptoms, and as experts explained, this skewed the estimated mortality rate. 

Because testing was limited at first, Italy's health authorities themselves admitted in spring that the true number of cases could be “up to ten times” higher than the official figure.

Dr Nino Cartabellotta, head of italy's evidence-based medicine group Gimbe, told The Local back in April that the country was “only seeing the tip of the iceberg” at that point.

Testing capacity has since increased vastly.

Previously the highest 24-hour toll of new infections during the first wave of infections was 6,557 on March 21st, with around 26,000 tests being carried out on that date.
 
As Italy reported a new record of over 10,000 new cases on October 16th, 152,000 tests had been carried out.

This difference makes it difficult to compare figures from March with those being reported in October. And more testing can't fully explain the rise in new infections, either.

While the number of tests carried out has risen, so has the percent of tests coming back positive. It is now around nine percent, compared to below one percent in July.

How does Italy's situation compare with other EU countries?

Though Italy's situation appears to be rapidly worsening, Italy's poltiicians are keen to point out that it is still behind the curve compared to some European countries.

Neighouring France is currently reporting around 30,000 new cases a day while the figure in the UK is around 18,000. Spain now reports only slighly more cases than Italy, at around 12,000 a day.

While Italy had a markedly lower number of infections than its neighbours until recently, things are becoming less clear-cut.

Italy had been widely praised in September for doing a comparatively good job of keeping a feared “second wave” at bay, but some commentators now ask if that praise was premature.

While the numbers are now rising again, Italy remains behind the curve thanks to measures implemented at the early stage of the pandemic. 

This means the country also had more time than most to recoup and prepare this summer, after its stringent measures kept cases down to around 200 a day in July.

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HEALTH

WHO expects more monkeypox-related deaths in Europe

The World Health Organization's European office said Saturday that more monkeypox-related deaths can be expected, following reports of the first fatalities outside Africa, while stressing that severe complications were still be rare.

WHO expects more monkeypox-related deaths in Europe

“With the continued spread of monkeypox in Europe, we will expect to see more deaths,” Catherine Smallwood, Senior Emergency Officer at WHO Europe, said in a statement.

Smallwood emphasised that the goal needs to be “interrupting transmission quickly in Europe and stopping this outbreak”.

However, Smallwood stressed that in most cases the disease heals itself without the need for treatment.

“The notification of deaths due to monkeypox does not change our assessment of the outbreak in Europe. We know that although self-limiting in most cases, monkeypox can cause severe complications,” Smallwood noted.

The Spanish health ministry recorded a second monkeypox-related death on Saturday, a day after Spain and Brazil reported their first fatalities.

The announcements marked what are thought to be the first deaths linked to the current outbreak outside Africa.

Spanish authorities would not give the specific cause of death for the fatalities pending the outcome of an autopsy, while Brazilian authorities underlined that the man who died had “other serious conditions”.

“The usual reasons patients might require hospital care include help in managing pain, secondary infections, and in a small number of cases the need to manage life-threatening complications such as encephalitis,” Smallwood explained.

According to the WHO, more than 18,000 cases have been detected throughout the world outside of Africa since the beginning of May, with the majority of them in Europe.

The WHO last week declared the monkeypox outbreak a global health emergency.

As cases surge globally, the WHO on Wednesday called on the group currently most affected by the virus — men who have sex with men — to limit their sexual partners.

Early signs of the disease include a high fever, swollen lymph glands and a chickenpox-like rash.

The disease usually heals by itself after two to three weeks, sometimes taking a month.

A smallpox vaccine from Danish drug maker Bavarian Nordic, marketed under the name Jynneos in the United States and Imvanex in Europe, has also been found to protect against monkeypox.

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